FLORIDA -- July 13,
2017 -- What is being called the largest ever health care fraud
enforcement action by the Medicare Fraud Strike Force, involving 412
charged defendants across 41 federal districts, including 115
doctors, nurses and other licensed medical professionals, was
announced on July 13 for their alleged participation in health care
fraud schemes involving approximately $1.3 billion in false billings.

In the Southern
District of Florida a total of 77 defendants were charged with
offenses relating to their participation in various fraud schemes
involving over $141 million in false billings for services including
home health care, mental health services and pharmacy fraud.

“Health care
fraud schemes have real, long-term consequences for our South Florida
community. Patients are being denied the quality of care that they
deserve, doctors are turning a blind eye to their oaths, and taxpayer
money is being diverted into the pockets of the greedy. Today’s
announcement highlights South Florida’s united and ongoing law
enforcement effort, culminating in charges against more than twenty
percent of the national defendants, to thwart evolving schemes and
combat the unlawful distribution of opioids and prescriptions drugs,”
Acting U.S. Attorney Benjamin G. Greenberg said

The following are
some of the cases included in the take down:

Sober Homes Fraud

1. United States v.
Eric Snyder and Christopher Fuller, Case No 17-MJ-8268-Brannon

Eric
Snyder, 30, of Delray Beach, Florida, an owner of sober homes and
addiction treatment facilities, and patient broker Christopher
Fuller, 32, of West Palm Beach, Florida, are charged in a criminal
complaint with conspiracy to commit health care fraud for their
involvement in a scheme to illegally recruit patients, pay kickbacks
and defraud health care benefit programs.

According to the
criminal complaint, Snyder established a sober home, Halfway There
Florida, LLC (HWT), also known as A Safe Place LLC, in Palm Beach
County, Florida, which was purportedly in the business of providing a
safe and drug-free residence for individuals suffering from drug and
alcohol addiction. The defendants referred the sober home’s
residents to a treatment center, Real Life Recovery Delray, LLC,
(RLR), which was also owned by Eric Snyder. This treatment center
purportedly offered clinical treatment services for persons suffering
from alcohol and drug addiction.

According to the
criminal complaint, to obtain patients for the sober home and
treatment center (collectively “HWT/RLR”), Synder and other
members of the conspiracy provided kickbacks and bribes, in the form
of free or reduced rent, airline tickets, and other benefits, to
individuals who agreed to reside at the sober homes, attend drug
treatment therapy sessions, and submit to regular drug testing that
members of the conspiracy could bill to the residents’ insurance
plans. These patient brokers, including Fuller, were also paid
kickbacks themselves by Snyder and others for referring patients to
HWT/RLR for purported treatment.

According to the
criminal complaint, fraudulent billings were submitted by HWT/RLR for
services that were not medically necessary and/or were never
provided. Licensed health professionals who used to work at HWT/RLR
describe treatment conducted by unqualified and non-licensed
employees, and billings for treatment that never occurred. The
licensed professionals were asked to sign for and/or backdate this
treatment as though they had conducted it. In addition, licensed
professionals at HWT/RLR were asked to complete intake forms and
other documents for patients that they had not seen. In
some instances, services were billed for residents who left the sober
homes and were no longer receiving treatment at the treatment
centers. In other instances, patients were billed for therapy
sessions they never attended, and therapy sign-in sheets and other
documents fraudulently reflected that these patients attended these
sessions, when they did not. The defendants provided services meant
solely to maximize insurance reimbursements, such as expensive urine
drug screens. HWT/RLR fraudulently used urine drug
screens as a profit-machine, including splitting samples to send them
to different laboratories, improper duplicate testing, and
fraudulently double billing for tests for the same patients at both
HWT and RLR. In addition, samples were fraudulently comingled prior
to testing to prevent identical test results from exposing the
scheme. After a search warrant was executed at a different treatment
facility in Palm Beach County, in September 2014, Snyder and others
attempted to stop or modify these illegal practices, and evidence of
this wrongful conduct was removed and destroyed.

According to the
indictment, Orlando Bustabad and his son Orlando Olver Bustabad were
the true owners of eight pharmacies located in Miami Dade County,
namely, Med Solution Pharmacy, 17th Street Pharmacy, Rapid
Pharmacy, Euro Pharmacy, A&B Pharmacy, Maxi Pharmacy, Mariposa
Pharmacy, and 49th Street Pharmacy. Orlando Bustabad and
Orlando Olver Bustabad operated these pharmacies under their own
names or enlisted co-conspirators Manresa, Escobar, Jimenez, Mena,
and Sierra to appear as owners. These pharmacies purportedly provided
prescription drugs to Medicare beneficiaries. From February 2013
until June 2017, the defendants submitted and caused the submission
of approximately $10,183,031 in claims for reimbursement to
the Medicare Part D program, via interstate wires, that falsely
and fraudulently represented that various health care benefits,
primarily prescription drugs, were medically necessary, prescribed by
a doctor, and had been provided by the pharmacies. As a result of
such false and fraudulent claims, Medicare prescription drug plan
sponsors made payments funded by the Medicare Part D Program to the
corporate bank accounts of the eight pharmacies in the approximate
amount of $4,649,743.

3.United States v.
Victor Rocha, Case No. 17-20409-CR-Altonaga

Victor Rocha, 49,
of Miami Lakes, Florida, was charged by indictment with six counts of
health care fraud. The indictment charges Rocha with falsely and
fraudulently submitting medical claims for prescription medications
for reimbursement to Medicare Part D from September 2012 through May
2013, through his pharmacy, Med Express Pharmacy Discount, Inc. The
Indictment charges that the claims were for prescription medications
that were not provided and/or not medically necessary.

Alejandro Hernandez
Rios, 35, of Miami, Florida, was charged by indictment with five
counts of health care fraud. The indictment charges Rios with falsely
and fraudulently submitting medical claims for prescription
medications for reimbursement to Medicare Part D from June through
September 2014, through his pharmacy Independence Pharmacy and
Discount, Inc. The indictment charges that the claims were for
various prescription medications that were not provided and/or not
medically necessary.

5.United States
v. Pedro Mangano, Case No. 17-20408-CR-Martinez

Pedro Mangano, 52,
of Miami, Florida, was charged by indictment with ten counts of
Medicare fraud. The indictment alleges Mangano was the owner and
operator of PVRX Pharmacy, located in Miami, Florida. Between March
2014 and June 2017, Mangano’s pharmacy submitted fraudulent claims
for allegedly dispensing drugs to Medicare beneficiaries that the
pharmacy never had in inventory to begin with. As part of the scheme,
Mangano paid patient recruiters for fraudulent scripts used to
defraud the Medicare Part D program. The fraudulent claims resulted
in overpayments exceeding $1.1 million.

On June 28, 2017,
William Salazar Ortega and Oscar Alonso Gonzalez were indicted in
connection with their roles at Latin Pharmacy, a pharmacy that
defrauded Part D of the Medicare program of $2.38 million by billing
for expensive prescription medications that were not prescribed to
patients; were not necessary; and were not purchased. Salazar was the
nominee owner of the pharmacy, and Gonzalez was its true owner. Each
defendant was charged with one count of conspiracy to commit health
care fraud and wire fraud and four counts of health care fraud.
Gonzalez is also charged with one count of money laundering.

7.United States v.
Yara Suarez, et al., Case No. 17-20453-CR-Moreno

On June 29,
2017,Yara Suarez, Jesus Sanchez, Anthony Moya and Yoel Concepcion
were indicted in connection with their roles at Albe Pharmacy, a
pharmacy that defrauded Part D of the Medicare program of $3.4
million by billing for expensive prescription medications that were
not prescribed to patients; were not necessary; and were not
purchased. Sanchez and Suarez were the owners of the pharmacy, and
are each charged with one count of conspiracy to commit health care
fraud and wire fraud, three counts of health care fraud and one count
of conspiracy to commit money laundering. Moya and Concepcion owned
and controlled shell corporations through which over $380,000 of the
fraud proceeds were laundered. Moya and Concepcion are each charged
with one count of conspiracy to commit money laundering and three
counts of substantive money laundering.

8. United States v.
Lisbet Cordova, Case No. 17-20450-CR-Cooke

On June 29, 2017,
Lisbet Cordova, the owner of Jalvarez Pharmacy, Inc. (“Jalvarez”)
was indicted on four counts of health care fraud. Through Jalvarez,
Cordova billed Medicare, pursuant to Part D of the Medicare program,
for prescriptions that were not medically necessary, prescribed or
dispensed to Medicare beneficiaries. As part of the scheme, Jalvarez
submitted approximately $730,000 in fraudulent claims to Medicare.

Jose De Jesus
Rodriguez, 47, of Miami, Florida, was charged by indictment with one
count of conspiracy to unlawfully distribute prescription drugs and
three substantive counts of improperly distributing prescription
drugs, also referred to as prescription drug diversion. The
indictment charges Rodriguez with illegally distributing millions of
dollars’ worth of prescription medications from August 2011 through
March 2015.

10. United States
v. Reynaldo Ocana, Case No. 17-MJ-02939-Otazo-Reyes

Reynaldo Ocana, 46,
of Miami, Florida, was charged by criminal complaint with improperly
distributing prescription drugs, also referred to as prescription
drug diversion. The criminal complaint charges Ocana with illegally
diverting prescription drugs in August 2016.

Hector Fajardo
Ramirez, 48, of Miami, Florida, was charged by indictment with six
counts of health care fraud. The indictment charges that Ramirez
falsely and fraudulently submitted medical claims for home health
therapy for reimbursement to Medicare from February through July
2015, through his clinic Longevity Home Health Services, Inc. The
indictment charges Ramirez with submitting claims for home health
services that were not medically necessary and not provided.

Duniesky Cruz, 50,
of Miami, Florida, the owner of home health agency Life & Hope
Healthcare, Inc., and an employee Carlos Gomez Bravo, 33, of Miami,
Florida, were charged by indictment with conspiracy to defraud the
United States and pay health care kickbacks and payment of kickbacks
in connection with a federal health care program. The charges stem
from their involvement in a home health fraud scheme involving
kickback payments to patient recruiters, patients, and clinic owners
in exchange for patient referrals and prescriptions.

13. United
States v. Vilma Alonso, Case No. 17-20468-CR-Ungaro

Vilma Alonso, 57,
of Hialeah, Florida, an employee of South Florida Physician Care
Network was charged by indictment with participating in a conspiracy
to defraud the United States. Alonso was charged with conspiring with
others to unlawfully enrich themselves by, among other things,
submitting and causing the submission of false and fraudulent claims
to Medicare and concealing the submission of false and fraudulent
claims to Medicare. Alonso allegedly did this by causing the issuance
of home health prescriptions that were not medical necessary and by
paying recruiters for the referral of Medicare beneficiaries for home
health services.

14. United States
v. Maria Blanco, Case No. 17-20474-CR-Williams

Maria Blanco, 50 of
Cape Coral, Florida, was charged by information with five counts of
receiving kickbacks in connection with a federal health care program.
The information charges Blanco with receiving approximately $8,500 in
kickbacks on at least five occasions in 2014.

On July 7,
2017, Enrique Vilarello and Alberto Ordaz were
each indicted on one count of conspiracy to pay and receive illegal
kickbacks. Ordaz was also indicted on two counts of receipt of
kickbacks in connection with a federal health care program. The
charges stem from their roles as patient recruiters, paying illegal
kickbacks to obtain medical prescriptions from clinics and receiving
illegal bribes for referring patients to pharmacies, and home health
agencies in and around Miami, Florida. Several of these entities,
such as Merfi and City Center, are now defunct as a result of their
owners being charged and pleading guilty to multi-million dollar
fraud schemes.

16. United States
v. Juan Rodriguez, Case No. 17-20347-CR-Scola

On May 25,
2017, Juan Rodriguez, President and Director of Good Home Care,
Inc., a now-defunct home health agency located in Miami, Florida, was
indicted on five counts of health care fraud for his role in a $4
million scheme. Good Home allegedly billed Medicare for home health
services that were never prescribed by a licensed physician or
provided to Medicare beneficiaries.

On June 22,
2017,Jesus Escobar Montero, President and Director of Better Care
Home Health Services, Inc., a now-defunct home health agency located
in Sunrise, Florida, was indicted on four counts of health care fraud
for his role in a nearly $1 million scheme. The charges arise from
Montero’s ownership of Better Care, which billed Medicare for home
health services that were never prescribed by a licensed physician or
provided to Medicare beneficiaries.

On June 22, 2017,
Carlos Barroso, Andres Perez, Rolando Perez and Reiniel Garcia were
indicted in connection with their roles at Sweet Home Health, Inc., a
home health agency that defrauded Part A of the Medicare program of
$8.4 million by billing for home health services that were not
prescribed to patients; were not necessary; and were not rendered.
Barroso was the owner of Sweet Home Health and was charged with seven
counts of health care fraud, as well as one count of conspiracy to
commit money laundering. A. Perez, R. Perez and Garcia owned and
controlled shell corporations through which the fraud proceeds were
laundered. They are each charged with one count of conspiracy to
commit money laundering, three counts of money laundering and three
counts of structuring to avoid reporting requirements.

On June 29, 2017,
Jhony A. Alfau, Hector J. Garcia, and Sergio E. Santana were indicted
on one count of conspiracy to commit health care and wire fraud, one
count of conspiracy to make false statements relating to health care
matters, and one count of making false statements relating to health
care matters.The charges stem from the defendants’ role in a $50
million scheme to defraud Medicare where they falsely and
fraudulently certified they provided home health care physical and
occupational therapy services to Medicare beneficiaries, when in
fact, they had not done so.

20. United
States v. Ernesto Velasquez, Case No. 17-20462-CR-Martinez

On July 5,
2017, Ernesto Velasquez, was charged by information with one
count of conspiracy to commit health care fraud. The charge stems
from the defendant’s role as an employee of staffing agencies that
sought to defraud the United States by billing Medicare for providing
licensed physical and occupational therapy to home bound patients
when, in fact, they had not rendered the services. As part of the
scheme, these alleged services were billed to Medicare with a loss of
over $3 million.

21. United States
v. Suley Cao, Case No. 17-20451-CR-Martinez

On June 29, 2017,
Suley Cao, the owner and operator of Good Friends Services, Inc.
(“Good Friends”), a home health agency, was indicted on five
counts of health care fraud; one count of conspiracy to defraud the
United States and pay Health Care Kickbacks; and two counts of
payment of kickbacks in connection with a federal health care benefit
program. The charges stem from Cao’s role as owner and operator of
Good Friends, which fraudulently billed Medicare for approximately
$3,017,276.89 for home health services that involved a scheme whereby
Good Friends made kickback payments to induce the referral of
Medicare beneficiaries.

22. United States
v. Rafael Arias et al., Case No. 17-MJ-02962-Garber

On July 13, 2017,
Rafael Arias, Aylen Gonzalez, Ana Gabriela Mursuli Caballero, and
Rafael Cabrera were charged by criminal complaint with conspiracy to
commit health care fraud for their roles in an approximately $6
million Medicare fraud scheme involving various home health agencies
in and around Miami, Florida. Arias was alleged to be the true owner
of multiple home health agencies, such as Nestor’s Health Services,
Inc. Arias hid the fact of his true ownership and instead directed
others, like Cabrera, to fraudulently represent themselves as owners
to Medicare, which allowed them to obtain Medicare provider numbers
and submit claims for services purportedly provided to Medicare
beneficiaries even though many of the services were medically
unnecessary or were obtained as a result of illegal bribes and
kickbacks. Gonzalez and Caballero were patient recruiters who
facilitated kickback schemes with Arias by referring patients to home
health agencies operated by Arias in exchange for bribes and
kickbacks. Gonzalez and Caballero also purchased medically
unnecessary prescriptions from fraudulent medical clinics. Caballero
also owned and operated City of Angels Home Health Care LLC, a home
health agency that she used to bill Medicare for home health services
that were medically unnecessary or were obtained as a result of
illegal bribes and kickbacks.

Assisted Living
Facility Fraud

23. United States
v. Bertha Blanco, Case No. 17-MJ-02949-Garber

On July 11, 2017,
Bertha Blanco, who was employed for approximately 30 years by the
State of Florida’s Agency for Health Care Administration (AHCA),
was charged by complaint with bribery of a program receiving federal
funds. AHCA is responsible for administering the Medicaid program in
Florida, and is tasked with regulating and licensing health care
facilities in Florida, including skilled nursing facilities (SNFs)
and assisted living facilities (ALFs). The charge alleges that Blanco
solicited and received cash bribes from Medicare and Medicaid
providers in exchange for providing them with confidential, nonpublic
AHCA reports and information, including patient complaints and the
unannounced inspection schedules of AHCA surveyors. This information
was ultimately used by the purchasers, some of whom were owners of
skilled nursing facilities (SNFs) and assisted living facilities
(ALFs), to fabricate and falsify medical paperwork and to temporarily
remedy deficiencies so that AHCA would not discover lapses in patient
care and revoke the licenses of these facilities. The owners of these
SNFs and ALFs then submitted false and fraudulent claims to Medicare
and Medicaid for patients named in the complaints and inspection
reports sold to them by Blanco.

Clinics, Managed
Care, Medicare Advantage Fraud – Medicare Part C

24. United States
v. Beatriz Carrasco, Case No. 17-20464-CR-Ungaro

On July 6, 2017,
Beatriz Carrasco, 49, of Hialeah, Florida was charged by information
with one count of conspiracy to commit health care fraud and wire
fraud. The information charges Carrasco, a Florida licensed insurance
agent, with conspiring to enroll others into Medicare Advantage plans
and Florida Medicaid. These individuals resided in Nicaragua, outside
of the Medicare Advantage plans coverage area. As a result of
Carrasco’s and her co-conspirator’s actions, Medicare and the
Florida Medicaid program paid over $1,013,244 in monthly capitation
payments and premiums on behalf of individuals residing in Nicaragua,
who were otherwise ineligible to receive these benefits.

25. United States
v. Greesy Misuraca, Case No. 17-20461-CR-Scola

On July 5, 2017,
Greesy Misuraca, a licensed therapist, was charged by information
with one count of conspiracy to commit health care fraud. The charge
stems from the defendant’s alleged role in billing Medicare for
licensed physical and occupational therapy that was given to home
bound patients when, in fact, she did not provide the therapeutic
services. As part of the scheme, these alleged services were billed
to Medicare with a loss of over $650,000.

Private Insurance Fraud (Non-Medicare)

26. United States
v. Leopoldo Becerra, Case No. 17-20470-CR-Moreno

Leopoldo Becerra,
50, of Miami, Florida was charged by indictment one count of health
care fraud. The indictment charges Becerra with using Doctor Jalal
Taslimi Medical Center, Inc., to falsely and fraudulently submit
medical claims for reimbursement to Blue Cross Blue Shield of Florida
from November 25, 2014 through May 25, 2015. The indictment charges
Becerra with submitting fraudulent claims for beneficiaries
purportedly receiving various injections.

27.
United States v. Jorge A. Gonzalez and Lazaro La Paz Paz,

Case No.
17-20440-CR-Martinez

Jorge A. Gonzalez,
50, of Miami, Florida and Lazaro La Paz Paz, 50, of Hialeah,
Florida are charged by indictment with one count of conspiracy to
commit health care fraud and wire fraud. The indictment charges
Gonzalez and La Paz Paz with using two companies, Xtra Health Center,
Inc & Gold Medical Center, Inc, and fraudulently representing
that medical services were prescribed by doctors and provided to
private insurance beneficiaries by these businesses. Gonzalez and La
Paz Paz then falsely and fraudulently submitted these medical claims
for reimbursement to Blue Cross Blue Shield of Florida from April
2014 through February 2015.

On July 6,
2017, Michael Shane Matthews, 47, of Newberry, Florida, was
charged by information with causing the misbranding of drugs while
held for sale.

29. United States
v. Asciano Serna, Case No. 17-20484-CR-Altonaga

On July 7, 2017,
Asciano Serna, owner and operator of ASC Pharmacy, Inc., was charged
by information with one count of conspiracy to commit health care
fraud. The charge arises from Serna’s role in a compounding
pharmacy scheme at ASC Pharmacy involving the submission of at least
$3.4 million of false and fraudulent claims to private insurance
companies, Medicare, TRICARE, and other federal programs.

Unlicensed Money Transmitting and Money and Laundering

30. United States
v. Yisel Torres, Case No. 17-20477-CR-Moreno

Yisel Torres, 31,
of Cape Coral, Florida was charged by information with one count of
participating as an unlicensed money transmitter. The information
charges Torres with cashing several checks totaling $135,000 from on
or about May 22, 2014, through on or about March 11, 2015. The
proceeds that Torres cashed were used to pay cash kickbacks to
Medicare beneficiaries that were enrolled in R&N Professional
Services.

31. United States
v. Angel Rivero, Case No. 17-20475-CR-Cooke

Angel Rivero, 43,
of Miami, Florida was charged by information with one count of
participating as an unlicensed money transmitter. The information
charges Rivero with cashing several checks totaling $100,000 from on
or about May 22, 2014, through on or about March 11, 2015. The
proceeds that Rivero cashed were used to pay cash kickbacks to
Medicare beneficiaries that were enrolled in Happy Heart Home Health
Care.

On July 11, 2017,
Yailyn Marimon and Yamilka Echeverria were indicted in connection
with their roles laundering money four Orlando-area medical clinics
stole from Part C of the Medicare program. The Clinics, which were
owned by Yosbel Marimon – the defendants’ brother and ex-husband,
respectively – billed Medicare for $13.8 million of expensive
infusion therapy drugs and physical therapy that were not medically
necessary, and were never provided. On June 26, 2017, Yosbel Marimon
was sentenced to 90 months’ imprisonment for his role in the
scheme. The indictment alleges that Yailyn Marimon and Yamilka
Echeverria laundered over $2 million of the fraud proceeds through
shell companies they owned and controlled. Each defendant was charged
with one count of conspiracy to commit money laundering and one count
of substantive money laundering.

If convicted of a
charged offense, a defendant faces a possible maximum statutory
sentence of: five years in prison for participating in a conspiracy
(to defraud the United States by paying and receiving health care
kickbacks or by unlawfully distributing prescription drugs), in
violation of Title 18, United States Code, Section 371; 20 years in
prison for mail fraud, in violation of Title 18, United States Code,
Section 1341; 20 years in prison for wire fraud, in violation of
Title 18, United States Code, Section 1343; ten years in prison for
health care fraud, in violation of Title 18, United States Code,
Section 1347; twenty years for conspiracy to commit health care fraud
and wire fraud, in violation of Title 18, United States Code, Section
1349; 20 years for money laundering or conspiracy to commit money
laundering, in violation of Title 18, United States Code, Section
1956; and ten years in prison for money laundering, in violation of
Title 18, United States Code, Section 1957; and five years in prison
for conducting an unlicensed money transmitting business, in
violation of Title 18, United States Code, Section 1960(b)(2). In
addition, a defendant may be subject to one year in prison for
misbranding a drug held for sale, in violation of Title 21, United
States Code, Sections 331(t) (prescription drug marketing violations
are subject to a maximum penalty of 10 years in prison, in accordance
with Title 21, United States Code, Sections 333(b)(1)(D), and
353(e)(1)(A)) and five years in prison for payment and receipt of
kickbacks in connection with a federal health care program, in
violation of Title 42, United States Code, Section 1320a.
Furthermore, if convicted of aggravated identity theft, in violation
of Title 18, United States Code, Section 1028A, a defendant faces a
mandatory consecutive term of two years in prison.

A criminal
complaint, information or federal indictment is a charging instrument
containing allegations. All defendants are presumed innocent, unless
and until proven guilty in a court of law.

Related court
documents and information may be found on the website of the District
Court for the Southern District of Florida at www.flsd.uscourts.gov
or on http://pacer.flsd.uscourts.gov.

The case was
announced on July 13 by Benjamin G. Greenberg, Acting United States
Attorney for the Southern District of Florida; George L. Piro,
Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami
Field Office; Shimon R. Richmond, Special Agent in Charge, U.S.
Department of Health & Human Services, Miami Regional Office,
Office of Inspector General (HHS-OIG); and Pam Bondi, Florida
Attorney General.Source: United States Attorney's Office, Southern District of Florida